If you’re a woman over the age of 45 and experiencing nagging hip pain, you might be dealing with one or more of these common conditions. From glute tendonopathy to bursitis, these issues can significantly impact your daily life. Understanding the type and source of your pain, and how to address it, is key to effective treatment. That’s why in this video, we’ll explore the four most common causes of hip pain and share evidence-based strategies to help you manage and alleviate your symptoms.
Chapter 1: Glute Tendonopathy – Causes, Symptoms, and Diagnosis
Glute tendonopathy is one of the most frequently seen causes of hip pain on the outside aspect of the hip. This condition is due to inflammation of the tendons connecting the glute muscles to the hip bone. Common symptoms include pain and tenderness in the outer side of the hip region, right along the glute tendon.
Activities that require the use of the glute muscle, such as walking, squatting, or climbing stairs, are often painful. It is also very common for people to have issues lying on the painful side.
Diagnosing gluteal tendonopathy involves a thorough physical examination, assessing tenderness of the tendon as well as strength and flexibility of the glute muscles. A simple test involves standing on one leg. If this causes pain along the outer part of the hip during the test, glute tendonopathy may be considered.
People with glute tendonopathy often exhibit what is called a trendelenberg gait, characterized by a noticeable hip drop while walking. Imaging studies like ultrasound or MRI can be utilized to confirm the suspicion of glute tendonopathy and rule out other possible causes. However, a good physical examination is often all that is needed.
Causes of glute tendonopathy include underlying weaknesses in the core or hip muscles, repetitive overuse, hip arthritis, and a history of back or knee issues.
Chapter 2: Effective Treatment Strategies for Glute Tendonopathy
Effective treatment should often include a combination of strategies to achieve the best possible outcomes. Pain reduction techniques, such as activity modification to minimize excessive strain on the tendon, along with therapies like massage and trigger point dry needling, can offer relief and help manage pain symptoms.
However, the key to long-term relief lies in restoring strength of the affected tendons. Tendons play a crucial role in moving our bones when muscles contract, so getting them strong enough to tolerate the stress of daily activities is the ultimate goal. But it’s important to recognize that progress may be slow, requiring patience and dedication. Tendons don’t strengthen overnight. Significant changes in tendon strength typically require over three months of consistent strength training.
While it’s common to receive prescriptions for anti-inflammatory medications or cortisone injections to alleviate pain, research suggests that these treatments may not be the best decision for tendon health. In instances where symptoms persist despite comprehensive rehab efforts, an MRI may be necessary to assess the overall condition of the tendon. And in cases where a tendon is torn, surgical intervention may be required to repair the damage.
Chapter 3: Bursitis – Causes, Symptoms, and Diagnosis
Bursitis is another common cause of hip pain in women over the age of 45. This condition rarely occurs by itself and often occurs alongside glute tendonopathy. It is characterized by an inflammation of the bursa that lives underneath the glute tendons. The bursa is a fluid-filled sac that helps to reduce the friction that can occur when the tendon moves over nearby bones.
Symptoms typically include localized pain and tenderness of the bony area of the hip. Just like glute tendonopathy, discomfort is often felt when walking or climbing stairs and lying on the painful side. The condition can be identified using diagnostic ultrasound, an inexpensive and easy assessment performed in most orthopedic clinics, or MRI.
The most common cause of bursitis is repetitive stress, which most often occurs due to weakness of the hips, including the glutes and hip external rotators.
Chapter 4: Managing Bursitis – Pain Management and Rehabilitation
Early pain management strategies may involve reducing spasms of the muscles in the area through techniques like massage and dry needling, along with incorporating progressive strengthening exercises to target the underlying weaknesses. In cases of severe pain, a local cortisone injection may be considered to alleviate inflammation and enhance tolerance to participating in movement and rehab. Surgery is generally not recommended for gluteal bursitis unless there’s an underlying issue such as tendon tearing.
Chapter 5: Osteoarthritis – Causes, Symptoms, and Diagnosis
Another very common condition experienced by women over the age of 45 is osteoarthritis. This occurs when the protective cartilage cushioning the ends of your bones breaks down over time. Pain is mostly felt in the groin region, along with the classic sensation of joint stiffness, particularly noticeable in the mornings or after periods of prolonged sitting, as well as deep increased flexibility in the hip joint.
Pain tends to develop gradually over time and is often irritated by higher impact or weight-bearing activity. Diagnosing osteoarthritis is very straightforward, involving a combination of physical assessment where the healthcare professional will assess the movement and strength of the hip, as well as x-rays to see the extent of joint changes.
The cause of osteoarthritis is due to a combination of factors, but some of the most relevant factors believed to contribute to an increased risk include age, genetics, past hip injuries such as joint trauma or previous surgeries, and obesity.
Chapter 6: Treating Osteoarthritis – Exercise, Weight Management, and Lifestyle Changes
Since osteoarthritis is a chronic condition, effectively treating this issue requires a combination of strategies. This includes exercise therapy, weight management, joint protection techniques, and lifestyle modifications such as improving nutrition.
You might wonder, how does nutrition affect arthritis? Well, arthritis is an inflammatory condition, so avoiding inflammatory foods can help manage pain. If pain remains a significant issue, your doctor may recommend pharmacological interventions like anti-inflammatory medications or cortisone injections to effectively alleviate pain and inflammation.
In addition to arthritis, another prevalent cause of groin pain is labral tears, which result from injury to the labrum, the cartilage ring lining the hip socket. Symptoms include clicking, locking, or catching sensations in the hip joint, along with deep, sharp, or aching groin pain and sensations of giving way are common. Surprisingly, labral tears are not always due to trauma, with most occurring over time. They can stem from various factors such as hip impingement, arthritis, hypermobility conditions like Ehlers-Danlos syndrome, and even congenital hip dysplasia.
Chapter 9: Rehabilitation Strategies for Labral Tears
Identifying a hip labral tear should involve a combination of clinical evaluation, including tests to assess the integrity of the labrum, as well as an MRI. The resulting pain from labral tears often leads to limitations in hip flexibility and weakness in the surrounding muscles, which can further intensify the issue.
Because the primary function of the labrum is to provide stability to the hip joint, the focus of rehab is on strengthening the muscles to restore control of the joint and reduce stress on the labrum. In cases where symptoms persist despite conservative interventions, surgical options like arthroscopic labral repair or debent may be necessary. However, these are typically reserved for individuals with severe symptoms who do not respond to physical therapy. Pain management strategies, such as anti-inflammatory medications or corticosteroid injections, may be utilized to alleviate pain and inflammation if deemed necessary.
4 Common Causes of Hip Pain in Women Over 45
So there you have it, four common causes of hip pain in women over the age of 45. Whether you’re dealing with tendonopathy, bursitis, osteoarthritis, or hip labral tears, there are effective strategies that can alleviate symptoms. The key to hip health is restoration of strength and flexibility, with additional measures such as improving nutrition and modifying activity to reduce inflammation and pain.
But remember, there are no quick fixes. Even surgery requires extensive time and energy to recover from. Your commitment to a comprehensive rehabilitation strategy is essential for long-term improvement. Through targeted exercises, healthy lifestyle habits, and guidance from a healthcare professional such as a physical therapist, overcoming hip pain and reclaiming your active lifestyle is possible. So keep motivated and never hesitate to seek support when needed. Your hips will thank you for it because, as Shakira says, “Hips Don’t Lie.”
